Promethazine Injection

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Promethazine Injection is a prescription antihistamine/sedative used for allergic reactions, nausea, sedation, and motion sickness—administered IM or IV, 12.5–25 mg every few hours.
Common effects include drowsiness and dry mouth; serious risks include respiratory depression in young children and tissue damage if improperly administered.
Avoid use in infants under 2; use caution with respiratory conditions, heart disease, sedatives, and when administering IV.

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Name:

Promethazine Injection

Category & Prescription Status:

First-generation antihistamine / Sedative
Prescription Only Medicine (POM)

Formulation:

Aqueous solution for intramuscular (IM) or intravenous (IV) injection
Available in strengths such as 25 mg/mL

Active Ingredient:

Promethazine, typically 25 mg per mL

Uses:

Treats or prevents allergic reactions, hives, and itching
Combined with analgesics to enhance sedation and anti-nausea effects
Used pre- and post-surgery for sedation and reducing nausea or vomiting
Off-label use: motion sickness, migraine-associated nausea, as a mild sedative

Dosage:

Adults: 12.5–25 mg IV/IM every 4–6 hours as needed
Children (2+ years): 0.5–1 mg/kg every 4–6 hours (max 25 mg per dose)
Dosage and frequency depend on patient age, condition, and route of administration

How It Works:

Blocks histamine H₁ receptors, reducing allergic symptoms
Exhibits central nervous system depressant effects that reduce nausea and provide sedation

Common Side Effects:

Drowsiness, dizziness, or sedation
Dry mouth, blurred vision, urinary retention
Local reactions at injection site (pain, irritation)

Serious Side Effects & Warnings:

Respiratory depression, especially in children under 2 years
Severe tissue injury (gangrene, necrosis) with IV infiltration—use IV administration cautiously
Risk of extrapyramidal symptoms (e.g., tremor, muscle stiffness)
Rare severe allergic reactions – rash, swelling, anaphylaxis
May prolong QT interval—avoid with certain heart medications or in heart disease

Precautions & Contraindications:

Do not use in children under 2 due to respiratory risks
Avoid IV administration with other irritant drugs
Use cautiously in patients with COPD, sleep apnoea, glaucoma, urinary obstruction, or benign prostatic hyperplasia
Avoid or adjust dose in liver or kidney impairment
Avoid with alcohol, sedatives, or opioids due to additive sedation or respiratory depression

Administration & Storage:

IM injections should be deep and well-diluted; IV given slowly and diluted to reduce tissue toxicity
Monitor injection site for redness or swelling
Store at controlled room temperature, protected from light; discard unused portion per guidelines